Penny Wise, Pound Foolish

Kidney transplant: $125,000
Immunosuppressant pills so the kidney isn't rejected: $1000-$3000 a month
Dialysis: $9300 a month

Which won't Medicare pay for?

Yeah. The pills. As this NY Times story relates, Medicare will pay for a kidney transplant (or even two), and it will pay for a life-time of dialysis. But it will only pay for three years of the immunosuppressants transplant patients need to have to retain their new kidney. This leads a large number of dialysis patients to keep themselves off the transplant lists, and costs Medicare $6300 to $8300 a month for each one of them. A recent study showed that Medicare spends an average of $17,000 a year on care for kidney transplant recipients, most of it for anti-rejection drugs. That compares with $71,000 a year for dialysis patients and $106,000 for a transplant (including the first year of monitoring).

And it's more than that. Someone who requires regular dialysis finds it hard to keep a job, considering how much time they spend hooked up to the machine. And you know they can't find other health insurance: this is definitely a pre-existing condition.

Just one more of the disconnects that makes "the best health-care system in the world" not quite.

(ps: The House reform bill addresses this. The Senate's doesn't.)